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Individual

AYANA L LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
10 CINDY CT, HAMPTON, GA 30228-2963
(832) 877-2086
Mailing address
10 CINDY CT, HAMPTON, GA 30228-2963
(832) 877-2086

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005788
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000000
NONE
GA
Enumeration date
08/02/2018
Last updated
10/30/2019
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